| John Scott Stadalsky, MD | |
| 105 Springhall Dr, Goose Creek, SC 29445-5370 | |
| (843) 766-6308 | |
| (866) 533-4473 | 
| Full Name | John Scott Stadalsky | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | 105 Springhall Dr, Goose Creek, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1699720250 | NPI | - | NPPES | 
| T83086 | Medicaid | SC | |
| 571020809007 | Other | SC | BCBS SC | 
| 571020809042 | Other | SC | TRICARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 24015 (South Carolina) | Primary | 
| Entity Name | Musc Affiliate Physicians | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1700465648 PECOS PAC ID: 6305241027 Enrollment ID: O20210818002996 | 
| Mailing Address | Practice Location Address | 
|---|---|
| John Scott Stadalsky, MD 1871 Savage Rd, Charleston, SC 29407-4726 Ph: (843) 531-9961 | John Scott Stadalsky, MD 105 Springhall Dr, Goose Creek, SC 29445-5370 Ph: (843) 766-6308 | 
| Jason Winkler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 110 Nnptc Cir, Goose Creek, SC 29445 Phone: 843-794-6000 | |
| Ms. Zoe Kleckner Pogue, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 99 Bridgetown Rd, Goose Creek, SC 29445 Phone: 843-572-3300 Fax: 843-797-3331 | |
| Thomas Plyler Hamilton, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Springhall Dr, Goose Creek, SC 29445 Phone: 843-766-6308 Fax: 866-533-4473 | |
| Nicholas Matthew Cundiff, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 99 Bridgetown Rd, Goose Creek, SC 29445 Phone: 843-572-3300 Fax: 843-797-3331 | |
| Dr. Christine Marie Suarez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 99 Bridgetown Rd, Goose Creek, SC 29445 Phone: 843-572-3300 Fax: 833-771-2207 | |
| Anna Harper Tucker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Springhall Dr, Goose Creek, SC 29445 Phone: 843-766-6308 Fax: 866-533-4473 |